Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taiwan.
Department of Respiratory Therapy, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan.
J Microbiol Immunol Infect. 2021 Aug;54(4):673-679. doi: 10.1016/j.jmii.2020.03.030. Epub 2020 Apr 8.
Mycoplasma pneumoniae is one of the major pathogens causing community-acquired pneumonia in children. Although usually self-limited, Mycoplasma pneumoniae pneumonia (MPP) may lead to complicated morbidity that can even be life-threatening. Upon MPP infection, alveolar macrophage becomes attracted and activated and will induce subsequent cytokine and chemokine reaction. Refractory Mycoplasma pneumoniae pneumonia (RMPP) is manifested by clinical or radiological deterioration despite proper antibiotic therapy. RMPP is characterized with excessive inflammation and may need subsequent glucocorticoid treatment.
The aim of this study was to investigate the change of plasma chemokines in non-refractory Mycoplasma pneumoniae pneumonia (NRMPP) and RMPP before and after antibiotic or methylprednisolone treatment.
A total of 42 children with MPP were enrolled in this study. Plasma specimens were collected at admission and one to two weeks after antibiotic or methylprednisolone treatment with declined fever. Plasma specimens were then indicated to chemokines detection.
Mycoplasma pneumoniae pneumonia altered the chemokine profile through the observation of decreased plasma M1 related chemokines (CCL2, CCL8 and CXCL10) and increased M2 related chemokines (CCL17 and CCL22) after treatment.When the patients were divided into RMPP and NRMPP groups and the chemokines before treatment were compared, the RMPP group showed higher CXCL10 but lower CCL3 and CCL11 than the NRMPP group.
Unique changes in macrophage related chemokines is observed in the course of MPP infection. NRMPP and RMPP infection in children showed distinct manifestation in chemokine profiles.
肺炎支原体是引起儿童社区获得性肺炎的主要病原体之一。虽然通常是自限性的，但肺炎支原体肺炎（MPP）可能导致复杂的发病率，甚至可能危及生命。在 MPP 感染后，肺泡巨噬细胞被吸引并激活，并会引发随后的细胞因子和趋化因子反应。难治性肺炎支原体肺炎（RMPP）表现为尽管给予适当的抗生素治疗，但临床或影像学仍恶化。RMPP 的特点是炎症过度，可能需要后续糖皮质激素治疗。
本研究旨在探讨非难治性肺炎支原体肺炎（NRMPP）和 RMPP 患儿在抗生素或甲基强的松龙治疗前后血浆趋化因子的变化。
本研究共纳入 42 例 MPP 患儿。在退热后抗生素或甲基强的松龙治疗 1-2 周时采集血浆标本。然后对血浆标本进行趋化因子检测。
肺炎支原体肺炎通过观察治疗后血浆 M1 相关趋化因子（CCL2、CCL8 和 CXCL10）降低和 M2 相关趋化因子（CCL17 和 CCL22）增加来改变趋化因子谱。当将患者分为 RMPP 和 NRMPP 组，并比较治疗前的趋化因子时，RMPP 组的 CXCL10 高于 NRMPP 组，而 CCL3 和 CCL11 则低于 NRMPP 组。
在 MPP 感染过程中观察到巨噬细胞相关趋化因子的独特变化。儿童 NRMPP 和 RMPP 感染在趋化因子谱上表现出明显不同的表现。
